Xie Yun, Xie Hui, Wang Rui-Lan
Intensive Care Unit, Shanghai General Hospital, Shanghai 201600, China.
World J Gastrointest Surg. 2025 Mar 27;17(3):103431. doi: 10.4240/wjgs.v17.i3.103431.
This letter responds to Wang 's recent publication on endoscopic biliary stenting for malignant obstructive jaundice (MOJ) by offering constructive feedback and suggestions for future research. We commend the authors for their comprehensive study design and execution, which included a clear delineation of study groups and a robust set of outcome measures. We suggest that future studies incorporate additional biomarkers, such as serum levels of liver enzymes and bilirubin, to provide a more nuanced understanding of liver function changes post-intervention. The study's focus on short-term survival rates is appreciated, but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes. Additionally, the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes. From a critical care perspective, we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications. We believe that incorporating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes, influencing future clinical guidelines and practice.
这封信通过提供建设性反馈和对未来研究的建议，回应了王最近关于内镜下胆管支架置入治疗恶性梗阻性黄疸（MOJ）的出版物。我们赞扬作者全面的研究设计和实施，其中包括对研究组的清晰界定和一套完善的结局指标。我们建议未来的研究纳入额外的生物标志物，如血清肝酶和胆红素水平，以便更细致地了解干预后肝功能的变化。该研究对短期生存率的关注值得赞赏，但我们建议探索更长的随访期，以全面了解生存结局。此外，使用经过验证的工具进行生活质量评估，能够提供更全面的患者结局视图。从重症监护的角度来看，我们主张整合先进的成像技术，以更好地描绘胆管解剖结构，并有可能预测治疗反应或并发症。我们认为纳入这些建议可以增强对内镜下胆管支架置入在MOJ管理中的作用及其对患者结局影响的理解，从而影响未来的临床指南和实践。
